Children's Vision (Oct 09)
The Vital Role of Good Vision in Childhood Development
by Carol E. Marusich, OD, MS, FCOVD
There is a wealth of research about the important role in early childhood vision plays to support sensory, motor, spatial, behavioral, and cognitive development. During the first three years babies learn how to use their senses together in a way that is unique to this phase of development and unmatched during all the rest of their years combined. They are learning how to learn thus laying the foundation from which all other understanding will develop.
How much and how well our children learn throughout life is determined largely by the variety of beneficial experiences in which they participate in their first few years of life.
Vision impairment, even small irregularities, can have a profound impact on development. Early diagnosis and prevention are the best approach to infant vision and eye health care because most conditions respond best to early treatment, before additional complications arise.
The American Public Health Association encourages a complete vision and eye health examination at the age of six months as does the American Optometric Association which also advises that screening does not replace a comprehensive examination. The goal of early examination, diagnosis, and treatment is to prevent vision and eye health conditions that can impede normal child development.
Many infants can have eye problems without any family history, predisposing health condition or triggering event. These children, unfortunately, are the ones we often see long after the damage is done because there were no easily detectable signs of trouble. Amblyopia with no eye turn; high nearsightedness, farsightedness or astigmatism which no one suspected; even a small tumor way off to the side in the retina which could not be seen during a screening— these could all be diagnosed during a comprehensive vision examination.
Some conditions and events increase your baby’s risk of vision problems. These include the following: infection, fetal drug or alcohol exposure, prematurity; birth weight less than 5lb. 8oz., medical conditions such as drug sensitivities, Down syndrome, Cerebral Palsy, Fragile-X syndrome, or deafness.
Family history of congenital or acquired conditions such as Retinoblastoma, congenital cataracts, and metabolic or genetic disease increase this risk. Any history of eye or head injury or abuse as an infant or toddler can lead to accompanying eye health and vision problems.
A baby’s eyes should look clear and healthy, without crusty eyelids, redness, or excessive tearing. They should look about the same size and color with equal eyelid openings and symmetrical appearance. Frequent eye rubbing, excessive blinking, or a tendency to close or cover one eye can indicate a problem. The eyes should be still when your baby looks at you, not shaking or vibrating side to side. They should not be excessively sensitive to light.
By six months of age, the eyes should line up and work together at all times and when looking in all directions. A “lazy eye” is not normal after six months of age.
They should be able to follow objects with their heads and eyes; make eye contact; respond to facial expressions; look toward objects and accurately reach for them. They should also be able to look toward sounds, favorite toys, and especially Mom and Dad.
There is not always an obvious correlation between behavior and underlying vision problems. More than once I have seen an infant with significant visual impairment and the only symptom was delayed motor development. If you can’t see what is out there, you are not very motivated to creep and crawl around to reach anything.
We only get answers to the questions we ask. If we want to know if our baby’s eye health and vision are developing normally, it makes sense to have that early eye examination.
So, as parents, grandparents, guardians, aunts and uncles, what can we do? Now that we better understand the need for early vision and eye health care, we can advocate for the children in our lives. If our toddlers and preschoolers have not yet been examined, make the necessary arrangements to do so.
For parents with little ones from six months to one year of age, I encourage you to take advantage of the American Optometric Association’s National InfantSEE Program which provides an assessment at no charge for all infants in this age group. To learn more about the program or schedule an appointment with a participating Optometrist in your area, visit the InfantSEE Program.
Working together, we can help all of our children achieve their full potential.
Carol Marusich, O.D., M.S., FCOVD, is in private practice at Lifetime Eye Care and lectures internationally on vision development and learning related vision problems. Visit her website for more information on vision and learning.
